Getting Feedback on Giving Feedback

Bryant Shannon

Emergency Medicine at MGH/BWH

PGY4 

I participated in the COE Clinical Teaching Skills Course along with residents and fellows across Partners’ Training Programs. This course caught my interest as an excellent supplement to my PGY4 curriculum. In our residency, the fourth-year resident supervises and teaches junior residents. The residency curriculum was designed to prepare graduates to transition into the role of academic clinician and medical educator after graduation. This requires a skill set different from the prior three years where the emphasis is on developing our clinical skills.  

I appreciate those attendings and senior residents who have been part my growth as mentors and educators. These interactions have shaped my own interests in becoming a medical educator. However, as much as I could easily identify who the great teachers are in our program, I never previously considered what made them so strong. The role of ‘pre-tending’ has not been as easy and seamless as I imagined. It is challenging to give junior colleagues thoughtful feedback that encourages them to flourish. This course gave me an opportunity to practice teaching and creating an optimal learning environment. 

Working with trainees from across specialties allowed for an exchange of unique perspectives and an opportunity to share best practices.

Implementing what we learned while on shift in the ED

One of the things I took away from the course was to engage with learners at the start of their shift to identify areas of focus. Having a preemptive discussion about specific areas the trainee is working on will allow me to be more specific and in tune with their goals. Narrowing the focus can allow for higher quality feedback that is more tailored to the individual. The course also introduced the R2C2 Feedback Model (see below). This four-stage model lays out the framework to high-quality feedback, emphasizing the importance of interpersonal skills.

This course also explored the human limitations with learning. This was a helpful realization for me as I often supervise junior residents while they are doing new procedures. When a learner is concentrating on a new procedural skill, it is nearly impossible for them to listen thoughtfully and digest feedback simultaneously. This will influence the way I teach procedures with the majority of instruction and feedback occurring not in real time but before and after.  

Finally, one of the lectures from the course discussed the evidence-based literature around cognition and retention of information. It was super interesting to hear about techniques for remembering and processing both concrete and abstract new information. I wish I had known more about these topics at the beginning of medical school, which would have helped me better digest the large volume of information thrown at us. As I prepare for my EM Boards and my Critical Care fellowship, I will be continuing to practice and better refine these skills both to improve myself as a learner and as an educator.